WHAT ARE HAEMORRHOIDS…?

Haemorrhoids can be likened to varicose veins. These are clumps of vessels which swell with any increase in pressure. Haemorrhoids occur equally in adult men and in women – particularly during pregnancy. They are thought to be associated with a lack of fibre in the diet and the undue straining this causes at toilet.

HAEMORRHOIDS CAUSE PROBLEMS BECAUSE THEY:

bleed

protrude

clot and become very painful

may itch

There are other causes for all these types of symptoms and it is important that if you have any of these symptoms seek medical attention from a General Practitioner or Specialist in this field – called proctology. As well as taking the history an examination of the area is compulsory. The clinic provides early or urgent access to a group of Specialist Physicians or Surgeons who are experienced in this field and Specialists in the appropriate tests or procedures, which may be required. An appropriate history and relevant tests will be expedited effectively and in a cost effective way.

FOR PATIENTS WITH HAEMORRHOIDS AFTER EXAMINATION, THE TREATMENTS RANGE FROM:

reassurance, dietary advice

local applications

injection

rubber band ligation

surgery

HAEMORRHOIDS ARE GRADED IN SEVERITY. THIS GIVES A GUIDE TO THE PREFERRED METHOD OF TREATMENT.

bleed only – may respond to diet and local applications (occasionally injection if bleeding severe)

prolapse with bowel movement but reduce spontaneously – suited for rubber band ligation

need to be pushed back in and associated with large skin tags – rubber band ligation or surgery may be required

permanently out – or thrombosed – very painful. Surgery may be required

MANY PEOPLE LABEL ANY PROBLEM IN THE AREA AS HAEMORRHOIDS OR PILES. IT IS IMPORTANT TO DISTINGUISH OTHER CAUSES OF:

bleeding

a lump

pain

irritation or discharge from other conditions of the bowel

BLEEDING FROM OTHER LOCAL CAUSES MAY BE:

skin tags

anal fissure

anal fistula

abscess

ulcer

polyps or cancer

BLEEDING MAY BE FROM HIGHER UP IN THE RECTUM OR BOWEL FROM CONDITIONS SUCH AS:

polyps

cancer

diverticular disease

These conditions can only be distinguished by the history and complete examination – the type of bleeding and the associated complaints may give an indication as to whether the condition is local or from higher in the bowel. For example the bleeding of haemorrhoids typically is bright red blood on the toilet paper and found to have spurted into the bowl with a bowel action. The blood is not usually mixed with the bowel action. Bleeding mixed with the bowel action suggests the source is higher in the bowel.

OTHER CAUSES OF A LUMP MAY BE:

skin tags

anal or low rectal polyps

a low cancer

prolapse of the rectum

an abscess, usually very painful

fistula, usually associated with a discharge

OTHER SYMPTOMS WHICH NEED TO BE CONSIDERED ARE:

abdominal pain

change of bowel habits

a sense of unsatisfied defecation (feeling like there is still something there)

weakness or tiredness due to anaemia

loss of weight

EXAMINATION:

An abdominal examination should be carried out first. This is followed by an inspection of the area, then a rectal examination. This is usually carried out with the patient lying on the side in the left lateral position. A gloved rectal examination is carried out unless there is a very painful condition obvious. Next a proctoscope or sigmoidoscope is inserted to examine the local area and the lower part of the rectum.

Flexible sigmoidoscopy and colonoscopy examine the bowel higher up or right around the whole large bowel. These procedures require prior arrangements and usually the use of a bowel preparation in a dedicated facility such as a day surgery centre.

EARLY CANCER DETECTION:

An important issue these days is cancer prevention. Surveillance, occult blood testing and colonoscopy all play an increasing role in detecting polyps early before they become malignant. Also cancers can be detected before they have spread and maybe cured.

CONDITIONS DEALT WITH AT THIS CLINIC AND PROCEDURES, WHICH MAY BE CARRIED OUT AS APPROPRIATE, NOT NECESSARILY AT THE TIME OF THE FIRST VISIT ARE:

sigmoidoscopy

flexible sigmoidoscopy

colonoscopy

drainage of a perianal haematoma

excision of a thrombosed haemorrhoid

excision of skin tag

injection of haemorrhoid

rubber band ligation of haemorrhoids

perianal abscess and ischio rectal abscess

anal fistula

pruritus ani

anal warts

rectal prolapse

pilonidal sinus and pilonidal abscess

ABOUT THE CLINIC:

There is a Specialist in attendance each day. We undertake to see you within one week of contacting us, and if required on the same day. A Specialist Nurse is in full time attendance to answer your queries and advise you on the most appropriate way to attend. If necessary a doctor will discuss some of the issues with you over the phone within 48 hours.

It is preferable to have a referral from a Practitioner. If you are contacting us by email please allow two to three working days for a response. If you do not receive a response please contact us by phone or fax again.

Contact

Consulting and operating at:

Masada Private Hospital

26 Balaclava Road
East St Kilda VIC 3183

Cabrini Private Hospital

181- 183 Wattletree Road
Malvern VIC 3144

Disclaimer

Welcome to this website devoted to the diagnosis and treatment of haemorrhoids and rectal bleeding. No symptom or complaint can be looked at in isolation.
The whole patient needs to be evaluated before any conclusions can be drawn or treatments instituted. This site is expanded to provide information in many related areas of patient concern.
Whilst all attempts have been made to ensure accuracy, the Clinic does not accept any liability for the use or application of this knowledge.
We are unable to provide any detailed feedback to your e-mails apart from general advice. Should you feel the need to contact us, an appointment can be made by e-mail or by telephone or fax.
To diagnose medical or surgical problems in this area, a formal consultation is required which includes a full history, thorough examination and any investigation that may be required.